Chapter 32 Health Maintenance, Health Promotion, and Wellness
Dec 19, 2015
32-2Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.
Health is the process through which a person seeks to maintain an equilibrium that promotes stability and comfort.
Health is a dynamic process that varies according to a person’s perception of well-being.
Health, Illness, and Wellness
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Health refers to all aspects of a person’s life.• Physical status• Emotional well-being• Social relationships• Intellectual functioning• Spiritual condition
Health, Illness, and Wellness
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Health, Illness, and Wellness
Illness is the inability of an individual’s adaptive responses to maintain physical and emotional balance, which results in an impairment of functional abilities.
Wellness is the condition in which an individual functions at optimal levels.
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Models of Health
Health is the maintenance of harmony and balance among body, mind, and spirit.• Balance or homeostasis is an equilibrium
among psychological, physiological, sociocultural, intellectual, and spiritual needs.
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Models of Health
Clinical model Health-belief model High-level wellness model Social learning theory Host-agent-environment model Health promotion model
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Cultural Influence on Health
Culture affects how an individual views health and illness.
One’s cultural background influences health-related behaviors and expectations of treatment when illness occurs.
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Family Influences on Health Care
Families help determine the following:• Whether or not to seek treatment.• What type of treatment is appropriate.• Who should provide the treatment or care.• Where the treatment or care should be
provided.
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Families are often the major caregivers for their relatives.
Extended families and communities have traditionally acted as a buffer against excessive stress and illness.
Family Influences on Health Care
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Family Influences on Health Care
Lack of social support from family or significant others results in psychological and spiritual isolation, which may negatively impact a person’s physiological state.
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Illness Perspectives
Illness is the result of a disease or injury that affects functioning and occurs when there is an inability to meet one’s needs.
An acute illness is usually characterized by a rapid onset, intense manifestations, and a relatively short duration.
A chronic illness is usually characterized by a gradual, insidious onset with lifelong changes, usually irreversible.
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Wellness Perspectives
Wellness places health on a continuum, from one’s optimal level (wellness), to a maladaptive state (illness).
High-level wellness means functioning to one’s maximum health potential while remaining in balance with the environment.
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Health Behaviors and Variables Influencing Health
Behavior is defined as the observable response of an individual to external stimuli.
All behavior has meaning.
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Health Behaviors and Variables Influencing Health
Variables Influencing Health • Lifestyle• Locus of Control• Self-Efficacy • Health Care Attitudes • Self-Concept• Cognition
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Health Behaviors and Variables Influencing Health
Variables Influencing Health• Age and Developmental Levels• Gender• Previous Experiences with the Health Care
System• Environment• Economic Resources
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Health Maintenance
Behavior directed toward maintaining a current level of health
Health maintenance activities are the activities/behaviors an individual performs to maintain or improve a current level of health.
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Health Maintenance
Characteristics of Health Maintenance• Perception• Motivation• Maintenance
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Health Promotion and Disease Prevention (Health Protection)
Health Promotion • Behavior motivated by the desire to shape a
health lifestyle.• Process of enabling people to increase
control over their health and to improve their health.
• Includes avoidance of unhealthy behaviors.• Health promotion efforts intervene with
healthy, rather than ill populations.
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Health Promotion and Disease Prevention (Health Protection)
Disease Prevention • Activities/behaviors that protect people from
the ill effects of actual or potential health threats
- Primary prevention- Secondary prevention- Tertiary prevention
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Health Promotion on a Global Level
World Health Organization • Organizes international conferences and
meetings and disseminates successful health promotion strategies, programs, and policies.
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Health Promotion on a Global Level
Fifth Global Conference on Health Promotion• Established Priorities for Health Promotion in
the 21st Century
“Healthy Cities” Movement• A vehicle to stimulate local-level health
promotion• Public, private, and nonprofit responsibility
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Health Promotion in the United States
Healthy People Initiative• Promote healthy behaviors.• Promote healthy and safe communities.• Improve systems for personal and public
health.• Prevent and reduce diseases and disorders.
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Assessment
Risk Factor Identification in Health Maintenance• Physical, environmental, psychological
behaviors that increase the vulnerability of an individual to disease or injury
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Assessment
Laboratory and Diagnostic Tests and Health Maintenance• Laboratory data includes cholesterol levels,
blood glucose, urine studies.• Health maintenance behaviors may be
measured with varieties of diagnostic tests and equipment.
• Client education about what to do with results obtained from these tests is given.
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Nursing Diagnosis
Ineffective Health Maintenance Health-Seeking Behavior Noncompliance Deficient Knowledge Ineffective Therapeutic Regimen
Management
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Planning and Outcome Identification
In many ineffective health maintenance situations, desired outcomes of care are best accomplished in small increments.
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Implementation
Health Promotion and Vulnerable Populations• Children• The Elderly• Economically Disadvantaged• Homeless
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Implementation
The Individual as a Holistic Being • The client with health maintenance
considerations is a holistic being.• Individuals function as complete units that
cannot be reduced to the sum of their parts.
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Implementation
Needs and Health • The entire person (mind, body, and spirit) is
influenced by satisfaction of needs.• Basic human needs are those that are
necessary for every person’s survival.
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Maslow’s Hierarchy of Needs
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Needs and Health
Physiological Dimension • Focuses on achievement of the basic needs
of a client.• The nurse must assess for system
alterations and then provide interventions to meet these needs.
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Physiological Dimension of Needs and Health
Physical Self-Examination Techniques Health Maintenance in Nutrition-
Management Behaviors Health Maintenance and Alterations in
Sleep Patterns
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Psychological Dimension of Needs and Health
Treating the client as a unique individual. Protecting confidentiality. Using touch and personal space in a
therapeutic manner. Recognizing and respecting cultural
differences. Decreasing anxiety through stress
management techniques.
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Sociocultural Dimension of Needs and Health
Empowerment is a process of enabling others to do for themselves.
Nurses empower clients by teaching them and their families how to develop skills for self-care and for healthier living.
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Intellectual Dimension of Needs and Health
Cognitive function and development can be impaired by multiple factors.• Infection• Exposure to toxins• Substance abuse• Trauma• Psychological problems
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Spiritual Dimension of Needs and Health
Spirituality assists a person in determining the sense of meaning or purpose in one’s life.
Spirituality is multidimensional.• A sense of one’s self• A sense of connection with others• A relationship with a higher power or divine
source
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Sexual Dimension of Needs and Health
Sexuality refers to all aspects of being male or female, including feelings, attitudes, beliefs, and behavior.
Sex roles are culturally determined patterns associated with being male and female.
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Evaluation
The client and nurse together measure how well the client has achieved the goals specified in the plan of care.
Factors that contribute to a goal achievement are identified.
Certain goals may need to be reevaluated.